Brain glucose metabolism and neuropsychological test in patients with mild cognitive impairment

Objective To investigate the features of regional cerebral metabolic rate of glucose （rCMRglc） in patients with mild cognitive impairment(MCI) by positron emission-tomography and its relationship with neuropsychological test.Methods Positron emission tomography, mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group. Results Scores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group (P<0.01). rCMRglc of the left orbital gyrus, right middle temporal gyrus and right putamen was lower in the MCI group than in the control group (P<0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus, putamen, left hippocampus and parahippocampal gyrus, cingulate gyrus, left amygdaloid body, precentral gyrus, postcentral gyrus, and medial occipitotemporal gyrus in MCI patients, were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen, temporal lobe, anterior cingulate gyrus, left insular lobe, amygdaloid body, precentral gyrus, postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen, temporal lobe, left insular lobe, precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen, the right inferior temporal gyrus, precentral gyrus, and left postcentral gyrus were correlated positively with the length of education. However, only rCMRglc of the left amygdaloid body were correlated positively with gender. Conclusion The rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity, age, length of education and sex.     

社交恐怖障碍患者执行功能与工作记忆能力研究

探讨社交恐怖障碍患者的执行功能、工作记忆能力与正常对照组的差异.方法 采用威斯康星分类卡片测验(Wisconsin Card Sorting Test,WSCT)以及数字广度、空间广度、多图形空间广度测验对42名社交恐怖障碍患者和42名健康对照者的执行功能、工作记忆能力进行评估.结果 在WSCT测验中,社交恐怖障碍患者非持续错误数明显高于对照组[分别为(18.75±6.20)分,(8.89±3.22)分],差异具有统计学意义.社交恐怖障碍患者工作记忆能力测验中数字广度[分别为(7.25±1.35)分,(8.03 ±2.30)分]、空间广度[分别为(6.11±1.85)分,(8.61±2.87)分]以及多图形空间广度[分别为(4.03±1.39)分,(5.18±1.07)分]成绩均低于对照组,差异具有统计学意义.结论 社交恐怖障碍患者存在工作记忆受损,而这可能是社交恐怖障碍患者学业以及社会功能不良的神经心理学机制.

Abstract：

Objective To explore the executive function and working memory ability of patients with social phobia. Methods The study included 42 social phobia patients whose age, sex, and level of education were matched with those of a healthy control group. Wisconsin Card Sorting Test and Digit Span, Spatial Span, Multiple-Objects-Spatial span were used to study the executive function and working memory. Results Patients with social phobia scored higher than the control group in terms of the number of non perseverative errors on the Wisconsin Card Sorting Test ( 18. 75 ± 6. 20, 8. 89 ± 3. 22 respectively ). No differences were observed in perseverative errors and other scores between the patient and control group. Patients with social phobia scored lower than the control group in terms of Digit Span(7.25 ±1.35,8.03 ±2. 30 respectively) ,Spatial Span(6. 11±1.85,8.61 ±2.87 respectively) and Multiple-Objects-Spatial span(4.03 ± 1. 39 ,5. 18 ± 1.07 respectively). Conclusion Working memory ability in the social phobia patients is impaired, and this may cause the poor performance in patients with the social phobia in academic and social working.     

Clinical Research of Acupuncture on Malignant Tumor Patients for Improving Depression and Sleep Quality

Objective:To study the effect of acupuncture on depression and insomnia of malignant tumor patients.Methods:Eighty cases of cancer related depression and sleep disorders were randomly divided into 2 groups:treatmentl group(acupuncture n=40) and control group(Fluoxetione n=40).All patients were assessed by Self-rating Depression Scale(SDS),Hemilton Depression Rating Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) after treatment for 30 days.Results:Before treatment the SDS and HAMD scores of the trial group were 64.12±5.34 and 20.92±2.38,those of the control group were 64.24±4.98 and 20.72±2.74,after treatment the SDS and HAMD scores of the trial group were 43.64±5.28 and 9.88±1.27 respectively,significantly lower than those of the control group(50.76±5.42 and 13.72±2.05 respectively,both P<0.05).Before treatment the PSQI score of the trial group and the control group were 14.48±1.71 and13.92±2.59,after treatment the PSQI score of the trial group was 7.92±1.22 after treatment,significantly lower than those of the control group(11.44±1.89,P<0.01).Conclusion:Acupuncture can effectively reduce malignant-related depression,improve sleep quality,and help to improve the quality of life of cancer patients.     

Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer's Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.     

Psychological Distress,Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction(stroke group) in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers(control group) were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90(SCL-90), the social support by the Social Support Rating Scale(SSRS), and medication adherence by Morisky’s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group(P<0.01). Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions(including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety) of SCL-90 were significantly higher in the stroke group than those in the control group(P<0.05, or P<0.01). The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group(P<0.05, or P<0.01). Those in the “SCL-90 total scores >150 group” were significantly higher than in the “SCL-90 total scores <100 group” and the “SCL-90 total scores between 100 to 150 group”(P<0.05, or P<0.01). Those in the “SCL-90 total scores between 100 to 150 group” were significantly higher than in the “SCL-90 total scores <100 group”(P<0.05). In 90 patients with ischemic stroke, 26(28.89%) patients obtained high medication adherence, 47(52.22%) patients medium medication adherence, and 17(18.89%) patients low medication adherence, respectively. Among these stroke patients, there were 17(50.00%) patients with high medication adherence in the “SCL-90 total scores >150 group”, 28(75.67%) patients with medium medication adherence in the “SCL-90 total scores between 100 to 150 group”, and 12(61.16%) patients with low medication adherence in the “SCL-90 total scores <100 group”, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients(P<0.05 or P<0.01). It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.     

Psychological Factors Are Closely Associated with the Bell’s Palsy: A Case-control Study

To observe the differences in psychological status between Bell’s palsy (BP) patients and healthy subjects, and to examine the relationship between psychological factors and the severity of BP, we conducted a case-control, multi-center clinical investigation. A total of 695 subjects were as-signed to the case group (n=355) and the control group (n=340). House-Brackmann grading system and Facial Disability Index (FDI) were adopted to assess the BP patients; Kessler Psychological Dis-tress Scale (K10) and 16 Personality Factor (16PF) scale were employed to evaluate the psychologi-cal distress and personality profiles of all subjects. Two independent samples t test was used to com-pare the differences between cases and controls, and to compare the differences among different BP patients. Pearson correlation analysis was used to examine the relationship between psychological factors and severity of facial paralysis. The results showed that psychological distress (K10) in case group (27.09±5.80) was significantly higher than that in control group (13.43±3.02) (t=-37.219, P=0.000). The scores of personality factor Warmth (A), Openness to Change (Q1), Self-Reliance (Q2) were lower in cases than in the controls (P<0.01, P<0.05, P<0.05, respectively), whereas the scores of Sensitivity (I), Vigilance (L), Apprehension (O), and Tension (Q4) were significantly higher in cases than in the controls (P<0.05, P<0.01, P<0.01, P<0.01, respectively). In addition, the psy-chological distress was significantly higher in female patients, severe (HB score Ⅳ-Ⅵ) patients, and subacute (onset time 72-168 h) patients compared with that in male patients, mild (HB score Ⅰ-Ⅲ)patients, and acute (onset time≤72 h) patients (P<0.05). The scores of personality factor in fe-male patients, severe patients, and subacute patients were also significantly different from male pa-tients, mild patients, and acute patients (P<0.05). The result of Pearson correlation analysis showed that psychological factors (K10, personality A, F, L, N, O, Q4) were closely related to HB scores. We are led to conclude that the psychological status between BP patients and healthy people are different; psychological distress and personality factors are closely associated with severity of facial paralysis.     

血管性痴呆患者执行功能与脑白质病变的相关性

目的 应用画钟测验(CDT)检测血管性痴呆(VaD)患者的执行能力,探讨其与头颅磁共振(MRI)白质病变的相关性.方法 对27例VaD患者和25例认知正常老年人进行自发画钟测验,评估其执行能力;同时依据年龄相关白质改变的评分方法(ARWMCrs)分别对受试者头颅MRI白质病变程度进行评分.结果 1.认知正常组CDT评分高于VaD组,差异具有显著性[分别为(3.88±0.33)分,(1.74±0.98)分,Z=6.26,P＜0.01].VaD组中数字部分、指针部分评分下降最明显;2.认知正常组与VaD组脑白质病变评分差异具有显著性[分别为(5.12±4.19)分,(11.19±3.09)分,Z=-4.54,P＜0.01];3.CDT与简明精神状态检查量表(MMSE)得分呈显著正相关(P＜0.01),与白质病变得分呈显著负相关(P＜0.01).结论 VaD患者的执行能力下降,与其脑白质病变程度可能有关.

Abstract：

Objective To explore the correlation between executive function and white matter lesions (WML) and the diagnostic value by clock drawing test(CDT) in patients with vascular dementia (VaD). Methods Twenty-seven VaD patients and twenty-five normal control subjects were evaluated with CDT to assess the executive function. CDT was scored according the four point method. Age-related white matter change rating scale (ARWMCrs) was used qualitatively to measure and locate the WML by cranial MRI scanning. Results 1. The scores of CDT in normal cognition health and VaD were ( 3.88 ± 0. 33 ) and ( 1.74 ± 0. 98 ). The difference between two groups was statistically significant (P＜0. 01 ). The humerous part and the point part were the earliest to decline in the VaD Patients. The scores of WML were (5.12 ± 4. 19) and ( 11.19± 3.09), respectively. There was significant difference between two groups(P ＜ 0. 01 ). The scores of CDT had significant positive correlation with MMSE scores and negative correlation with WML scores (P ＜ 0. 01 ). Conclusion The executive functional impairment in patients with VaD could be associated with the degree of WML.     

首发抑郁症患者重复神经心理测查系统临床应用研究

目的 用重复神经心理测查系统(RBANS)和Stroop色词测验探讨首发抑郁症的认知功能损害特点.方法 采用重复神经心理测查系统(RBANS)和Stroop色词测验分别对230例首发抑郁症患者和178例健康对照进行检测.结果 在Stroop色词测验中,抑郁症患者完成单字、单色、双字、双色所需要的时间[(14.37±6.65)s,(21.58±8.70)s,(16.56±8.23)s,(37.88±13.67)s]均长于对照组[(12.38±3.34)s,(18.01±5.51)s,(14.17±4.37)s,(32.87±10.28)s],差异有显著性(P＜0.05),但颜色干扰、字义干扰两组的结果没有明显差异,无统计学意义(P＞0.05).在RBANS测查中,抑郁症患者5个因子所得的分数[(72.19 ± 17.22)分,(80.89 ± 15.29)分,(82.00±16.37)分,(98.74±17.01)分,(82.09±14.62)分]均差于对照组,且差异有统计学意义(P＜0.05).相关分析显示,RBANS总分及5因子与HAMD总分及各因子相关无统计学意义;与教育程度正相关(P＜0.05),与性别相关无统计学意义(P＞0.05).RBANS总分及5因子中的即刻记忆、言语功能、延时记忆分别与年龄、病程呈负相关(P＜0.05).而视觉广度、注意与年龄、病程相关无统计学意义(P＞0.05).结论 首发抑郁症患者存在比较严重的记忆、注意、执行功能等全面认知功能的损害.

Abstract：

Objective To investigate the damaging traits of cognitive function in first episode depression patients with the assessment of neuropsychological status ( RBANS) and Stroop Color-word Test. Methods Two hundred and thirty first-episode depression patients as experimental group and one hundred and seventy-eight health person as control were evaluated separately by repeatable battery for the RBANS and Stroop Color-word Test. Results In Stroop Color-word Test,the time required for completing the words,color,double-word,two-color in depression patients ( (14.37 ±6.65)s,(21. 58 ±8. 70) s,( 16. 56 ±8. 23)s, (37. 88 ± 13. 67) s) were longer than the control group ((12.38 ±3.34)s, (18.01 ±5.51) s, (14. 17 ±4. 37) s, (32. 87 ± 10.28) s). The difference between the two groups was found in cognitive function in first episode depression patients (P ＜ 0.05). The scores of color interference and meaning interference were no difference between the two groups (P＞0.05) . The patients'scores of the RBANS test in all items( (72.19 ± 17.22), (80.89 ± 15.29), (82.00 ± 16.37) , (98.74 ± 17.01) ,(82.09 ± 14.62) )were significantly poorer than those in healthy controls. Compared with control group, scores of the scales were significant difference between two groups. Pearson correlation analysis showed that RBANS total score and five factors had no correlation with HAMD total score and factors. It positively correlated with education level (P＜0.05) ,but not with sex (P＞0.05). Immediate memory,verbal function,delayed memory in five factors and RBANS total score negatively correlated with age and course of disease respectively, but breadth of vision,attention were not did(P＜0.05). Conclusion First-episode depression patients suffer from more serious and comprehensive damage of cognitive function such as memory,attention,executive function.     

COGNITIVE AND EMOTIONAL IMPAIRMENT IN OBSTRUCTIVE SLEEP APNEA SYNDROME

Objective To evaluate the emotional and cognitive status in patients with obstructive sleep apnea syndrome (OSAS),using neuropsychological tests and evoked-related potential (P3).Methods Sixteen patients diagnosed of OSAS were tested by Hamilton rating scale for anxiety (HRSA) and Hamilton rating scale for depression (HRSD). Other three groups, OSAS patient group (n = 21), snoring group (n = 21), and control group (n = 21), were administered polysomnography (PSG), auditory evoked event-related potential (P3), and clinic memory test. The results were analyzed using general linear model (GLM) analysis and Post Hoc test.Results Twelve OSAS patients' scores of HRSA and HRSD were beyond the normal range, 26.42 ± 4.48 and 22.08 ±3.97 respectively. The auditory P3 latency in OSAS group was 363.1 ± 22.9 ms (Fz), 368.57 ± 28.03 ms (Cz), in snoring group 336.57 ± 31.08 ms (Fz), 339.81 ± 31.76 ms (Cz), in control group 340.8 ± 28.7 ms (Fz), 338.29 ± 29.21 ms (Cz).There were significant differences between OSAS group and snoring group, as well as control group (P ＜ 0.05). No significant difference was seen between snoring group and control group. No significant difference was noted in P3 amplitude among three groups. Memory quotient (MQ) reduced in snoring group compared with control group.Conclusions Emotional disturbances are common clinical features in OSAS patients. Abnormal auditory P3 latency indicates the cognitive dysfunction in OSAS patients. Nocturnal hypoxaemia may play an important role on it. Snorers should be monitored because of the tendency to develop cognitive impairment.     

Clinical effect of Astragalus granule of different dosages on quality of life in patients with chronic heart failure

Objective:To explore the dose-effect relationship of Astragalus granule(AG) on improving the quality of life(QOL) of the patients with chronic heart failure(CHF).Methods:Ninety CHF patients of Fei(肺)-qi deficiency and/or Xin(心)-Shen(肾) yang-deficiency syndromes were equally randomized divided with a random number table into three groups;they received the high(7.5 g),moderate(4.5 g),and low dosage(2.25 g) of AG orally taken twice a day,respectively,and 4 mg of perindopril tablet once a day for 30 successive days.The heart function grade,patients’ left ventricular ejection fraction(LVEF) and walking distance in 6 min(6mWD) were measured before and after treatment,and the patients’ QOL was scored by the Minnesota Questionnaire for QOL evaluation in the patients with CHF at the same time.Results:The heart function grades of all the three groups after treatment were improved compared with those before treatment,but the improvements in high-dose group and moderate dose group were better than that in the low dose group(P<0.05).LVEFs were increased significantly in all the three groups,but the improvements in the high-dose group(59.42%±7.50%) and moderate dose group(61.98%±6.82%) were better than that in the low dose group(51.45%±6.80%,P<0.01); the 6mWDs in the all groups were also significantly increased(P<0.01),up to 419.80136.23 m,387.15134.13 m, and 317.69±39.97 m,respectively;and Minnesota scores in them were lowered to 29.59±4.69 scores,35.74±5.89 scores,and 42.78±6.06 scores,respectively;comparisons in aspects on 6mWD and Minnesota score showed that the effectiveness with high dose is the most effective,moderate dose as the second,and low dose as the lowest(P<0.01).Conclusions:AG was sufficient to display an optimal effect on improving heart contraction at the moderate dose.In aspects of improving the QOL of CHF patients,the effectiveness of AG showed a dosedependent trend.It should be applied discriminatively depending on the actual condition of patients and the aim of treatment in clinic.     

有氧联合阻抗对颅脑损伤认知障碍患者执行功能及焦虑抑郁情绪的影响

目的 探讨有氧联合阻抗对颅脑损伤认知障碍患者执行功能及焦虑抑郁情绪的影响。 方法 2014年8月-2016年2月选择在哈尔滨医科大学附属第一医院进行康复治疗的颅脑损伤认知障碍患者144例,采用区组随机化方法将研究对象分为观察组与对照组各72例,对照组给予常规康复干预,观察组在对照组干预的基础上给予有氧联合阻抗干预,2组干预观察周期为4周。 结果 观察组与对照组干预后的NIHSS评分分别为(2.94±1.43)分和(4.20±1.98)分,都明显低于干预前的(6.02±1.45)分和(6.02±1.97)分(均P<0.05),干预后观察组的NIHSS评分(38.40±5.66)分和(34.98±5.30)分也明显低于对照组(44.98±6.13)分和(43.98±5.67)分(P<0.05)。观察组的执行功能依从性为98.6%,而对照组为88.9%,观察组的执行功能依从性明显高于对照组(P<0.05)。观察组与对照组干预后的SAS和SDS评分都明显低于干预前(均P<0.05),并且观察组在干预后的SAS和SDS评分也明显低于对照组(均P<0.05)。 结论 有氧联合阻抗应用于颅脑损伤认知障碍患者,能改善患者神经功能,提高训练执行功能,缓解焦虑抑郁情绪。      

急诊内快速顺序插管在脑外伤及脑卒中患者中的应用

目的：观察快速顺序插管（RSI）技术在脑外伤及脑卒中患者急诊气管插管中的临床应用效果。方法：98例脑外伤及脑卒中符合研究入选标准的患者,根据随机数字表随机分成试验组、对照组各49例,试验组行RSI,对照组行部分镇静表面麻醉下经口气管内插管,观察记录喉部显露的C/L（Cormack-Lehane）分级、插管时间、插管次数、血压变化、心率变化、SPO2的最低下降值及并发症;计算IDS评分及比较总体有效率。结果：两组插管时间试验组（20.05±5.50）s比对照组（31.58±9.34）s短,差异有统计学意义（P〈0.05）;试验组声门显露的C/L分级、插管次数、插管过程中收缩压、心率波动及SPO2的最低下降值均显著优于对照组（P〈0.01）;试验组并发症发生率低,其IDS评分及总体有效率（93.87%）显著优于对照组（p〈0.01）。结论：RSI应用于脑外伤及脑卒中患者急诊气管插管安全迅速有效,对比部分镇静表面麻醉下经口气管内插管有明显优势,值得临床推广。     

安宫牛黄丸治疗重型颅脑损伤的神经保护作用及对肠黏膜通透性的影响

目的:探究安宫牛黄丸治疗重型颅脑损伤（STBI）的神经保护作用及对肠黏膜通透性的影响。方法:选择STBI病人180例作为研究对象,按照随机数字表法分成观察组和对照组,各90例,其中对照组病人采取常规药物治疗,观察组病人在对照组治疗的基础上采用安宫牛黄丸治疗。比较2组病人治疗前和治疗后5 d、10 d时格拉斯哥昏迷评分、血清神经元特异性烯醇化酶（NSE）水平、白细胞介素（IL）-6水平、乳果糖排泄率和血浆二胺氧化酶水平变化情况,分析2组病人临床疗效和并发症发生情况。结果:观察组病人治疗总有效率为95.6%,高于对照组的80.0%（P<0.05）;观察组治疗后5 d和治疗后10 d的格拉斯哥昏迷评分明显高于对照组（P<0.01）,血清NSE水平和IL-6水平均明显低于对照组（P<0.01）;观察组治疗5 d和10 d的乳果糖排泄率和血浆二胺氧化酶水平均明显低于对照组（P<0.01）;各项并发症发生率均低于对照组（P<0.05~P<0.01）。结论:安宫牛黄丸可以有效降低STBI病人血清NSE含量及IL-6水平,抑制机体炎症反应,并能明显改善病人肠黏膜通透性,促进病人受损神经和胃肠黏膜功能恢复。     

神经干细胞移植对脑挫伤大鼠神经功能恢复神经元存活和轴突再生的影响

目的 观察神经干细胞(NSCs)移植对脑挫伤大鼠神经功能恢复影响,并探讨其机制.方法 24只SD大鼠以投币法分为3组:假手术组、手术组和NSCs移植组.采用自由落体致大鼠皮质运动区脑损伤模型,将培养纯化并鉴定的NSCs于术后当天移植入损伤位点周围;术后0d、3d、7d、14d行神经功能缺失(NSS)评分,观察动物运动和平衡功能缺损与恢复情况;14d时取脑组织用免疫荧光技术检测hochest标记的移植NSCs在体内存活、迁移;用神经元核蛋白(NeuN)、生长相关蛋白(GAP-43)抗体检测并计数宿主神经元存活和局部轴突再生.结果 与假手术组比较,脑外伤组大鼠脑挫伤后即出现不同程度抽搐,瘫痪,平衡功能缺失.神经功能缺损评分较假手术组明显升高,并随时间推移有所降低.而NSC移植组的NSS评分至第7天后与单纯手术组比较有明显减少[(4.38±0.74)分,(5.50±1.07)分,P＜0.01].Ho-chest标记的移植NSCs能在宿主脑组织存活,并向四周迁移.免疫组化染色显示宿主NeuN阳性神经元[(51.46±3.303)个,(42.83±5.401)个,P＜0.01]和GAP-43阳性纤维数量[(13.3±1.7)个,(8.7±1.1)个,P＜0.01]在NSC移植组明显增多.结论 NSCs移植能在挫伤脑组织存活、迁移,并促进宿主神经元存活、局部轴突再生和改善脑挫伤大鼠神经功能.     

创伤性脑损伤患者早期心肌酶谱改变的临床研究

目的：探讨创伤性脑损伤患者发生早期心肌酶谱改变与病情严重程度的关系。方法：采用回顾性分析,观察组患者65例,根据入院时GCS评分分为两个亚组：重型（含特重型）脑外伤组（GCS≤8分）15例,轻中型脑外伤组（GCS 9~15分）50例;健康对照组32例,为同期住院耳鼻喉科患者。入院24 h内测定血清心肌酶（ME）[谷草转氨酶（AST）、肌酸肌酶（CK）、肌酸肌酶同工酶（CKMB）、乳酸脱氢酶（LDH）、α-羟丁酸脱氢酶（HBDH）]。结果：脑外伤患者心肌酶升高发生率为75.4%,对照组心肌酶基本正常,两组AST[（35.98±27.70）U/L vs（18.19±3.90）U/L];CK[（531.28±602.20）U/L vs（89.13±41.80）U/L]、CKMB[（24.05±18.00）U/L vs（12.97±4.20）U/L]、LDH[（227.46±88.90）U/L vs（154.75±26.70）U/L]、HBDH[（175.26±60.20）U/L vs（118.63±18.60）U/L]比较,差异有统计学意义（P〈0.05）。病情越重（GCS评分低,死亡风险高）,ME值含量越高。死亡患者ME值含量明显高于存活者。结论：急性创伤性脑损伤患者ME值含量升高,早期检查心肌酶可作为伤情判断的指标之一,有利于对患者病情的全面评价。     

不同部位损伤对颅脑外伤患者认知功能的影响

目的：探讨不同部位损伤对颅脑外伤患者认知功能的影响,为颅脑损伤患者认知功能损害的早期诊断和治疗提供参考依据。方法：采用简易智能状态检查量表（ MMSE ）和中文版蒙特利尔认知评估量表（ MoCA）对222例颅脑外伤患者进行认知功能测评,比较不同损伤部位对认知功能的影响。结果：不同部位损伤的颅脑外伤患者认知障碍的发生率差异有统计学意义（P＜0.01）,其中额叶组视空间及执行功能评分明显低于其他各组,丘脑组延迟回忆评分与顶叶、枕叶和基底节组差异有统计学意义（ P＜0.05）。而颞叶组注意力评分及语言能力评分明显低于其他各组,差异有统计学意义（ P＜0.05）。结论：不同部位脑损伤患者认知障碍的发生率及认知损害的特点不同。     

关节镜下肩袖损伤修复术后的护理分析

目的：对患者关节镜下肩袖损伤修复术后护理措施分析。方法方便选取2012年6月＿2015年12月在该院就诊的62例肩袖损伤患者,随机的分为对照组和实验组两组,每组有31例患者,对照组患者实施常规护理,实验组患者实施术后护理干预,比较两组患者临床护理效果、并发症的发生率以及护理质量评分对比分析。结果对照组优良率为58.06%;而在实验组优良率为83.87%;在对照组中,并发症发生率为29.03%;而在实验组中,并发症发生率为6.45%;并发症发生率差异有统计学意义(P<0.05﹚;对照组在护理质量的5个指标的得分上均低于实验组;对照组总得分为(74.22±3.86﹚分,低于实验组(94.51±4.21﹚分,差异有统计学意义(P<0.05﹚。结论对关节镜下肩袖损伤修复术后患者实施护理干预可以显著的改善患者的临床症状,在临床中具有推广和应用的价值。     

护理分组管理对血液透析质量及安全性的影响

目的探讨护理分组管理对血液透析质量及安全性的影响。方法选取2013年3月至2015年2月于我院进行血液透析的患者88例为研究对象,随机分为观察组和对照组各44例,对照组实施常规管理,观察组在对照组基础上给予护理分组管理,采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评价两组干预前后情绪状态,应用生活质量评价量表(SF-36)、护理满意度评分表比较其生活质量及护理满意度,同时分析两组治疗依从性及血液透析相关知识知晓率,并记录血栓、感染等并发症发生率。结果干预后观察组HAMA评分(7.12±0.46)分、HAMD评分(5.91±0.24)分与对照组比较明显较低(P0.05);观察组SF-36评分(130.95±2.78)分、护理满意度评分(89.74±1.23)分高于对照组(P0.05);观察组依从性95.5%及血液透析相关知识知晓率88.6%较对照组86.4%、70.5%高(P0.05);观察组并发症发生率6.8%与对照组22.7%比较明显较低(P0.05)。结论护理分组管理可有效提高血液透析质量及安全性。     

氧自由基在创伤性大鼠脑损伤后肠道细菌移位中的作用

目的 探讨氧自由基在创伤性脑损伤大鼠肠黏膜屏障应激性变化机制中的作用.方法 雄性Wistar大鼠64只,随机分为2组:创伤性脑损伤(TBI)组(32只)和对照组(32只),再分别按术后6、12、24、48 h时相点分为4个亚组(n=8).测定肠黏膜组织丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽(GSH)水平,检测肠系膜淋巴结等多器官的组织匀浆中标记大肠杆菌的检出率.结果 TBI组多脏器荧光标记大肠杆菌检出率明显高于对照组(6、12、24、48 h组分别为:8.3%比2.1%、25.0%比2.1%.27.1%比2.1%、12.5%比0.0%,均P＜0.05);同时,该组各时相点肠黏膜组织匀浆中MDA含量明显高于对照组(nmol/mg pro,6、12、24、48 h组分别为:4.9±0.7比2.6±0.3、6.1±0.8比2.8±0.5、5.9±0.4 比 2.6±0.3、5.3±0.5比2.7±0.4,均P＜0.05);而GSH(mg/gpro,6、12、24、48 h组分别为:287±36比408±53、192±25比421±46、160±48比432±35、241±31比394±51,均P＜0.05)、SOD(U/mg pro,6、12、24、48 h组分别为:19.5±3.3比21.1±1.9、11.8±2.6比20.7±5.3、13.3±3.3比20.0±3.3、15.1±1.5比21.2±3.2,均P＜0.05)则明显低于对照组.结论 创伤性脑损伤模型大鼠伤后早期肠黏膜通透性升高,导致细菌移位增加,氧自由基在这一病生理过程中起重要作用.     

脑外伤病人血清巨噬细胞炎性蛋白1α含量 及其与病情严重程度的相关关系

目的检测脑外伤病人血清巨噬细胞炎性蛋白1α（MIP-1α）含量检测并探讨其与病情严重程度的相关关系。方法选择脑外伤病人98例作为观察组,并根据观察组MIP-1α含量中位数进一步分为高MIP-1α组、低MIP-1α组各49例,另取同期在本院进行体检的健康人50名作为对照组。同时采用格拉斯哥昏迷评分法（GCS）评估观察组病人的昏迷程度,测定其血清神经损伤指标、兴奋性氨基酸含量。结果入院时,观察组血清中MIP-1α含量为（92.16±9.85）pg/mL,显著高于对照组的（74.51±8.68）pg/mL（P < 0.01）。高MIP-1α组GCS评分为（7.27±0.91）分,显著低于低MIP-1α组的（11.09±1.82）分（P < 0.01）。入院时,高MIP-1α组血清中神经损伤指标胶质纤维酸性蛋白、神经元特异性烯醇化酶、S100B蛋白含量及兴奋性氨基酸谷氨酸、天冬氨酸含量均显著高于低MIP-1α组（P < 0.01）。结论脑外伤病人血清MIP-1α含量上升,且具体含量与脑损伤严重程度呈正相关。